Individual
MR. MICHAEL S GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2119 HIGHWAY 33, SUITE B, HAMILTON SQUARE, NJ 08690-1740
(609) 581-5303
(609) 631-6839
Mailing address
PO BOX 10439, TRENTON, NJ 08650-4039
(609) 581-5303
(609) 631-6839
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA05912000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050071446
RAIL ROAD MEDICARE
NJ
01
—
0658805000
AMERIHEALTH PRODUCTS
NJ
01
—
1097352
HORIZON MERCY
NJ
05
—
5531802
—
NJ
Enumeration date
10/03/2005
Last updated
11/16/2011
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